In April of 2024, the New York Executive and the New York Legislature released and enacted Article VII budget language bills changing, in addition to many other changes, the Consumer Directed Personal Assistance Program (“CDPAP/CDPAS”) under the New York State Medicaid program requiring a transition from a local fiscal intermediary (“FI”) to a statewide FI, by April 1, 2025. See, Part II of the HMH Art. VII (S.8307-C/A.8807-C) of the Governor’s budget.  Click here for NYS DOB FY 2025.

Under the New York Community Medicaid Program, once a person has applied and been determined eligible, they can choose one of the following programs to be enrolled in:

1. Immediate Need & Managed Long-Term Care (MLTC) which includes; Personal Care Services Program (PCSP)-Agency model & Consumer Directed Personal Assistance Program (CDPAP)
2. Nursing Home Transition and Diversion Medicaid Waiver Program (NHTD)
3. Traumatic Brain Injury Waiver (TBI)
4. Program for All-Inclusive Care for the Elderly (PACE).

The Medicaid program provides services to chronically ill or physically disabled individuals who have a medical need for help with activities of daily living (ADLs) or skilled nursing services. Services can include any of the services provided by a personal care aide, home attendant, home health aide, or nurse. Through the CDPAP/CDPAS program recipients (also known as “Consumers”),or their designee, i.e. agent, the consumer, instead of having an agency, directs their own services (“self-directing”) and has the flexibility and freedom in choosing their caregivers, which may include an existing private caregiver, a friend, a neighbor and/or a family member (other than a spouse or parent of a minor child). The tradeoff to having an agency supply the aides, etc., is that the consumer or their designee, i.e. agent, must manage the services, and are responsible for recruiting, hiring, training, supervising, terminating and arranging for back–up coverage when necessary and keep payroll records.

To participate in this program the consumer is required, by the Medicaid program, to contract with a FI to process the payroll and monitor and insure some additional basic requirements are met, i.e. training.  To date this has been certain local home care agencies.  The new law eliminated the ability to use a local home care agency as the FI and replaced it with one statewide FI to be selected by the state. New York has now selected a Georgia-based company Public Partnerships, LLC, [hereafter referred to as “PPL”], an organization that does not appear to have a good track record to date. This will be a very significant change to the program and may make the program more difficult and unattractive to stay in. We are monitoring its progress and are available to help you should the changes go into effect. You do not need to do anything today. There is litigation pending, legislation being offered, and advocacy being done at high levels. For more information you can go to www.cdpaanys.org/consumer-resource-center. This is an organization advocating for the program for consumers and agencies.

On November 12, 2024 the Governor, in response to the advocacy, instead identified 24 fiscal intermediaries that will join a new statewide partnership to provide services under the State’s new single statewide fiscal intermediary (“SFI”) consumer direct program. As the rest of the Governor’s announcement makes clear, these 24 entities were selected to be PPL’s subcontractors. The State will continue to announce additional “partners” to PPL in the coming weeks. According to the Governor’s website, this “statewide partnership is expected to begin in January and take full effect by April 1.” Click here to read full announcement here and the FI subcontractors selected.